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People in need of care, chronic or acute, often present problematic food intake and special nutritional needs. Integrated, person-centred and pro-active food and nutritional care delivery has been proven effective for people in health care. However, skills mismatches have been reported in different professions involved, which also applies to the role of chefs in healthcare. The EU funded project NECTAR aims at closing this gap by creating a new job profile, called Chef Gastro-Engineering (CGE). The current publication summarizes the status quo in hospitals and gives a perspective on the future role of chefs in integrated healthcare delivery. [ABSTRACT FROM AUTHOR]

Introduction: Rates of falls increase with ageing and age-related biological and functional changes. Most falls in later life occur as a result of a complex interaction between multiple intrinsic and environmental risk factors. Falls and falls-related injuries are major public health problems that often require healthcare intervention and rehabilitation (1) and recurrent falls are a frequent trigger for older people and their families seeking long term institutional care. Therefore, the prevention and management of falls has substantial relevance for integrated care systems. This study sought to obtain international insight into the implementation of pathways or programs addressing balance, mobility and/or falls prevention in primary care or community services. Methods: A survey template was created to include the key elements detected during a literature review conducted by MUG. The template included questions on screening, assessment, intervention components, target group, professionals involved and tools used for assessment and/or monitoring experience and outcomes. Members of IFIC's international Special Interest Groups(SIGs) on Ageing and Frailty, Intermediate Care were invited to complete an online EU Survey tool available from 01.06-01.08.2021. Responses were analysed by two researchers and results considered by the co-authors in an online focus group. Results: 16 people from 11 countries completed the online survey. 9/16 reported fully implemented falls programs or care pathways in their region or country: UK (3), Ireland (1), Spain (1), Indonesia (1), Peru (1), Australia (1) and Northwest USA (1). Seven examples are focused on older citizens but one is for older people with frailty & neurodegenerative diseases (New South Wales, Australia) and one is a pathway for patients in Indonesia, independent of disease and/or age limits. Professional disciplines involved differed across countries but allied health professionals and nurses were commonly involved. Family physicians were involved in only the examples from the USA and Indonesia. Specialist physicians in geriatric medicine were involved in five of the examples. Five programs involved pharmacists to advise on medication and two programs involved trained volunteers. Public/patient information and education was the most common intervention and was the sole intervention in the Spanish example reported. Three of the nine programs did not routinely evaluate patient experience or functional outcomes. Only three pathways enabled patient level data to flow through the electronic care record. Conclusion: The international survey offers initial insight into implemented pathways and programs for the prevention and management of falls in primary care and community settings in different countries. It paves the way for a more targeted survey and Delphi consensus process on the design and benchmarking of integrated services to address the challenge of falls in ageing societies. Implications: The evidence-based examples in the survey highlight processes and interventions that are readily transferable and where adoption will facilitate standardization and improved quality of care. The next phase aims to agree key components and performance indicators to allow future benchmarking and system-based evidence generation on prevention and management of falls in the community. [ABSTRACT FROM AUTHOR]

Introduction: Polypharmacy and medication non-adherence in the older population are growing public health issues throughout the European Union (EU), and are critical issues in integrated care. SIMPATHY (Stimulating Innovation Management of Polypharmacy and Adherence in The Elderly) is a consortium of 10 organizations representing 8 EU countries with the goal of stimulating innovation around polypharmacy and adherence, ultimately providing the tools for EU policy makers to adopt new programs addressing this issue into existing healthcare systems. Methods: A mixed-methods case study is ongoing to characterize the Italian policies on the management of polypharmacy in the elderly. A desk review of these policy documents and guidelines at the national, regional and local level has been completed. Documents from the Scientific Societies (Italian Society of Pharmacy Hospital, Italian Society of Pharmacoeconomics, Geriatric and Gerontology Society, Internal Medicine Society, General Practioners Italian Society), Italian Medicine Agency (AIFA), were included for analysis. Next to that documents from the Campania region (about 6 millions), and specifically Naples metropolitan area (about 1 million inhabitants) were taken as an example of regional and local implementation. Key informant interviews will be conducted with policymakers and clinicians responsible for developing these activities, to highlight the lack of specific policies and delineating strategies for implementing polypharmacy programs. Focus groups consisting of policymakers, clinicians and patients will then be used to validate the research findings. Final analysis will be completed in April 2016. Progress report: The issue of management of polypharmacy in the elderly has not been fully addressed on a national level in Italy. Some region developed polypharmacy consensus papers or local policies (Toscana, Lombardia, Emilia Romagna) just suggesting some alert or warnings on potential inappropriateness prescription in the elderly. Although the awareness of stakeholders on the needing for developing strategies for polypharmacy management; the present desk review analysis highlights the lack of policies at a national level and the need for developing a comprehensive practical guideline. In addition, a lack of a specific multidisciplinary approach for polipharmacy management was further addressed. Full results including key informant interview and focus groups will be presented. Conclusion: Results from key informants will further elucidate _why_ polypharmacy policies have never been implemented and _how_ these policies can be developed. These results combined with the other SIMPATHY case studies with lack of policies wil l provide valuable tools for policymakers, researchers, and clinicians throughout Europe as they move to integrate polypharmacy and adherence activities into existing health care systems. Funding: This poster is part of the SIMPATHY project (663082) which has received funding from the European Union's Health Programme (2014-2020). [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine is becoming increasingly important for delivering top-quality care to European citizens to cope the aging populations, rising costs and higher demand of care [1]. It is already established that telemedicine adoption varies among different countries [2]. Furthermore, the increased need for effective business models to implement eHealth solutions is already shown [3]. A one-size-fits-all implementation strategy (derived from a generic business model) for a Pan-European e-Health innovation, will most likely not succeed without either adapting the technology and services or differentiating the business models, according to differing health and social systems [4]. This is already indicated in similar studies with Electronic Health Record cases [5]. This case study examines a European, ICT-supported e-Health service in two different health and social systems and the subsequent implementation strategies. Methods: The PERSSILAA project was chosen as a case. This community-based, ICT supported service model was developed to detect and prevent frailty and functional decline in older adults [6]. We identified differences in a descriptive between-case-analysis for Italy and The Netherlands. Five steps were taken: 1) an inventory of the barriers, 2) review of the evidence 3) tailoring of the business models 4) implementation of the innovation and 5) assessment of the effects. Results: A one-size-fits-all business model and hence implementation strategy turned out to fail due to differences in adoption and implementation possibilities in the two different health and social systems. We present the Italian and Dutch and implementation strategy for the PERSSILAA eHealth solution and compare the differences in the business models. These differences results in different strategies, as example how to use the innovation when Dutch users use it privately at home on a multiple devices while the innovation in Italian is community-based and use one device in a group meeting. Conclusion and discussion: A pan-European eHealth business model and implementation strategy is an illusion. We reflect on the necessity of tailoring business models to regional context in order to allow further (business) exploitation and scale-up of eHealth solutions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic puts health and care systems under pressure globally. This current paper highlights challenges arising in the care for older and vulnerable populations in this context and reflects upon possible perspectives for different systems making use of nested integrated care approaches adapted during the work of the EU-funded project VIGOUR ("Evidence based Guidance to Scale-up Integrated Care in Europe", funded by the European Union's Health Programme 2014-2020 under Grant Agreement Number 826640)., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2020 The Author(s).)